What is Respiratory Medicine?

Respiratory medicine is the branch of medicine that treats people with diseases affecting the lungs.

The role of our lungs is to deliver oxygen into our bloodstream and remove carbon dioxide.  When you breathe in, air passes through the throat into the windpipe (trachea). The base of the windpipe divides into the right and left tubes (bronchi) which divide again and again each time getting smaller and smaller until the air sacs called the alveoli are reached. The alveoli act like balloons i.e. when you breathe in they inflate and when you breathe out they relax.

Oxygen moves across the walls of the alveoli and enters the bloodstream and is carried to the rest of the body after passing through the heart. Carbon dioxide is passed from the blood into the alveoli and is breathed out of the lungs.

What are the disease/complications included in this branch of medicine?

Respiratory medicine deals with a range of problems including:

Asthma

COPD

Lung Cancer

Tuberculosis, or TB (a bacterial lung disease)

Cystic fibrosis (an inherited condition that causes a sticky section that can affect the airways often causing infection)

interstitial lung disease (scarring of the lung tissue between and supporting the air sacs)

chronic cough

sleep disorders relating to breathing, e.g. obstructive sleep apnea

pulmonary vascular disorders (affecting the blood circulation of the lungs) and so on

In recent statistics showed that Respiratory Diseases including COPD, Tuberculosis, Lung Cancer are rising among the people of our country especially in urban areas. What are the causes and how can we prevent these diseases?

According to the latest WHO data published in 2017 Lung Disease Deaths in Bangladesh reached 68,462 or 8.69% of total deaths. The age adjusted Death Rate is 69.07 per 100,000 of population ranks Bangladesh #6 in the world.

It is sarcastic that a country which is renowned for its scenic greenery has its capital labelled as the 2nd most polluted city in the world in terms of air quality. According to the Global Air Report of 2017, the poor air quality in Dhaka and across Bangladesh claims over 1,22,400 lives every year.

In developing nations such as Bangladesh, the leading cause of death due to air pollution revolves around the fact that access to proper diagnosis and subsequent treatment are limited. Besides the outrageous rate of fatality, victims of air pollution are initially subjected to respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD), tuberculosis, asthma and lung cancer for an extended period of time.

The rise in respiratory diseases in Bangladesh is due to increasing air pollution. Dhaka scored 556 in the Air Quality Index (AQI), which is categorized as ‘extremely unhealthy’. Six common air pollutants include ozone, particulate matter, carbon monoxide, nitrogen oxides, sulphur dioxide and lead. Smoking tobacco is also a prevalent cause of respiratory diseases.

Even though respiratory diseases as a whole is an epidemic in Bangladesh, a great number of people in our society are not well aware of the diseases involved. Therefore, widespread health awareness is required to reduce fatality rate caused by these deadly diseases. Special attention has to be given to teenagers and discourage them from smoking tobacco products.

Public and private organizations should fund awareness campaigns. Strict laws should be implemented for industries to reduce carbon emissions. Anti-tobacco policies should be strengthened.

We do often get the report that people, suffering from Respiratory Diseases are going to abroad for better treatment.

As a doctor’s point of view, what do you think about the improvement of the services rendered by our govt. and other private medical institutions in the country?

A recent estimate of Bangladesh Investment Development Authority, which was prepared using the data of Health Bulletin 2012, says Bangladeshis spend $2.04 billion annually on healthcare abroad.

The amount is 1.94% of the country’s total GDP.

Currently we are having all the world class, modernized treatment facilities except lung transplantation for treating respiratory diseases.

The treatment cost in Bangladesh is half one of that of India and one-third to one-tenth of the amount in Thailand and Singapore. Considering the cost of critical surgeries, many find the overall hospital bills abroad similar to those estimated in local private clinics. Hence, numerous people prefer not to get treated at local hospitals.

It is not unusual that a certain number of people will prefer overseas treatment. But a change in mindset is key to increasing people’s confidence in local treatment.

Our country is incurring losses in its health economy, gradually posing a great threat to the national economy. In the case of referrals, it is fine or else there is no need to go abroad when we can cater to our patients with international standards treatment at home. Millions of dollars are funneled abroad every year. If we fail to stop it right now, our entire medical service system and foreign currency reserve will collapse.

The policymakers rethink this issue and work on its root

cause to help restore the reputation of the health sector in Bangladesh.